The role of electrophysiologic study for prediction and treatment of life-threatening arrhythmias.
The prognostic significance of drug therapy based on the electrophysiologic study (EPS) was examined during a mean follow-up period of 32 months in 45 patients with sustained ventricular tachycardia (SVT) and in 87 with nonsustained VT (NSVT), and in 7 survivors of cardiac arrest. The drug treatment during the follow-up period was divided into EPS-guided therapy and empirical therapy; in the former therapy, an effective drug for prevention of induced VT by EPS was given and in the latter therapy, an empirical drug was used because there was no effective drugs by EPS. Occurrence of SVT or sudden cardiac death was considered as an arrhythmic event. Of 45 patients with SVT, Group I consisted of 32 cases with organic heart disease (OHD) and Group II, 13 without OHD. In Group I, arrhythmic event occurred in only 2 of 15 patients with EPS-guided therapy, whereas 9 of 13 cases with empirical therapy had arrhythmic event (p less than 0.01). In Group II, no arrhythmic event was observed in the 9 patients with EPS-guided therapy, whereas it was seen in 3 of the 4 patients with empirical therapy (p less than 0.05). Of 87 patients with NSVT, 61 cases had OHD (Group III). SVT was induced by EPS in 13 patients in Group III. Arrhythmic event was not observed in 8 patients with EPS-guided therapy, whereas it was seen in 3 of the 5 patients with empirical therapy (p less than 0.05). Arrhythmic event occurred in 2 survivors of cardiac arrest who underwent empirical therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Sakurada
H
H
Department of Cardiology, Tokyo Metropolitan Hiroo General Hospital, Japan.
Motomiya
T
T
Hiraoka
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013610:Tachycardia / Q000175:diagnosis* / Q000188:drug therapy
D000889:Anti-Arrhythmia Agents